DESCRIPTION: Key features of welfare reform from an income maintenance entitlement (AFDC) to temporary cash assistance in exchange for work (TANF) are strict work requirements, sanctions, and time limits on eligibility. The expected outcome of this reform is self-sufficiency through employment. Underlying welfare reform is the assumption that TANF recipients are as able to work as women in the general population. There is increasing recognition that a subset of the TANF population face barriers to work and self-sufficiency based on significant disability due to -serious mental illness (SMI). Access to behavioral health services by this at-risk population may be in jeopardy as a consequence of changes to welfare entitlements and declines in Medicaid enrollment. Employment for these women can be facilitated by access to effective behavioral health services. This pilot study examines these research concerns by identifying patterns of service use of the AFDC/TANF population with SMI and determining whether female heads of households with SMI who had received behavioral health services before leaving welfare continue to receive services after leaving TANF. Findings from this pilot study will be used to determine the feasibility of conducting a full-scale longitudinal study of the impact of welfare reform outcomes on heads-of-households currently or formerly receiving welfare that have SMI. The specific aims of the pilot are to: Identify patterns of service use of the target population of current and former female heads-of households with SMI receiving AFDC/TANF who used Medicaid reimbursed behavioral health services in Philadelphia, PA, between 1997 and 2000. Determine whether leaving welfare reduces access to treatment for women with SMI who used Medicaid behavioral health services while on AFDC/TANF. Develop a research design for a longitudinal study of the impact of welfare reform outcomes on current and former heads-of-households receiving welfare that have SMI, to submit as an R01 or a career development award proposal.